• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.958-964
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• 2022

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of borderline or low-grade malignancy, and its prognosis is unpredictable. Herein, we describe the case of a 47-year-old asymptomatic female with a diagnosis of multinodular PEH. During a 7-year follow-up, the nodules with large size and high ¹⁸F-fluorodeoxyglucose uptake in the initial study showed progression with increasing sizes; however, most small nodules (size < 1 cm) demonstrated spontaneous regression with peripheral rim or nodular calcification. The patient underwent surgical resection for an enlarged nodule. Of note, it is unusual for an individual to have mixed progression and regression concomitantly, which may be helpful in predicting the prognosis.

• Korean Journal of Radiology
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• v.23 no.10
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• pp.998-1008
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• 2022

Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan-Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02-6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion: Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.105-112
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• 2009

Background: Solitary pulmonary nodules (SPN) are encountered incidentally in 0.2% of patients who undergo chest X-ray or chest CT. Although SPN has malignant potential, it cannot be treated surgically by biopsy in all patients. The first stage is to determine if patients with SPN require periodic observation and biopsy or resection. An important early step in the management of patients with SPN is to estimate the clinical pretest probability of a malignancy. In every patient with SPN, it is recommended that clinicians estimate the pretest probability of a malignancy either qualitatively using clinical judgment or quantitatively using a validated model. This study examined whether Bayesian analysis or multiple logistic regression analysis is more predictive of the probability of a malignancy in SPN. Methods: From January 2005 to December 2008, this study enrolled 63 participants with SPN at the Kangnam Sacred Hospital. The accuracy of Bayesian analysis and Bayesian analysis with a FDG-PET scan, and Multiple logistic regression analysis was compared retrospectively. The accurate probability of a malignancy in a patient was compared by taking the chest CT and pathology of SPN patients with <30 mm at CXR incidentally. Results: From those participated in study, 27 people (42.9%) were classified as having a malignancy, and 36 people were benign. The result of the malignant estimation by Bayesian analysis was 0.779 (95% confidence interval [CI], 0.657 to 0.874). Using Multiple logistic regression analysis, the result was 0.684 (95% CI, 0.555 to 0.796). This suggests that Bayesian analysis provides a more accurate examination than multiple logistic regression analysis. Conclusion: Bayesian analysis is better than multiple logistic regression analysis in predicting the probability of a malignancy in solitary pulmonary nodules but the difference was not statistically significant.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.500-518
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• 1996

Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

• The Korean Journal of Cytopathology
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• v.9 no.2
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• pp.193-199
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• 1998

Sclerosing hemangioma is a rare, benign neoplasm of the lung, usually presented as a solitary pulmonary nodule in an otherwise asymptomatic middle-aged woman. Cytologically it shows papillary, sheet, and cyst-like arrangements representing three main histologic patterns of papillary, solid, and angiomatous ones, respectively. Herein, we report the fine needle aspiration cytology of 5 cases of sclerosing hemangioma of the lung. The most characteristic finding is cyst-like spaces Intimately related to the papillary or solid cell nests. The tumor cells are relatively monotonous round to oval, small to medium in size. They have small amount of eosinophilic cytoplasm. The nuclei are uniform, round and have small but conspicuous nucleoli. The tumor cells in one of the presenting cases are large with abundant cytoplasm and show moderate nuclear pleomorphism. The nuclear chromatin, however, is fine and even without exception, even in the case showing nuclear pleomorphism. Major differential diagnoses based on the cytologic findings are well-differentiated papillary adenocarcinoma, bronchioloalveolar carcinoma, and carcinoid tumor.

• The Korean Journal of Cytopathology
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• v.12 no.2
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• pp.111-115
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• 2001

Solitary fibrous tumor on the pleura is rare but should be included in the differential diagnosis on a peripheral pulmonary nodule. Cytologic features of solitary fibrous tumor of the pleura is not familar to the pathologist and may be misdiagnosed as malignancy. We report fine needle aspiration cytologic(FNAC) findings of a case of solitary fibrous tumor misdiagnosed as adenocarcinoma in a 48-year-old woman. The FNAC displayed a mixture of bland-looking spindle cells and clusters of epithelioid cells, which have hyperchromatic nuclei with prominent nucleoli. The helpful finding to distinguish It from other circumscribed benign and malignant lesions is the presence of fibromyxoid matrix admixed with blood vessels and thin collagen fibers. Familiarity with these features is essential to avoid misdiagnosis and overtreatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.5-10
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• 2016

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.671-674
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• 1999

At OPD follow-up in December 1998, chest x-ray of a 42-year-old female showed a solit ary pulmonary nodule at a superior basal segment in the right lower lobe. After percut aneous transthoracic needle aspiration failure, wedge resection of the superior basal segment of lower lobe in right lung was performed for diagnosis and therapy. Three years ago, she had received surgery to remove a mass in the left buttock. The mass was pathologically diagnosed as malignant fibrous histiocytoma. She subsequently received 4500 rad radiotherapy for 35 days. Pathology confirmed metastatic malignant fibrous histiocytoma of the lung.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.171-174
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• 1988

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium- 99mTc-IDAs scan have shown that 99mTc-IDA s can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1833-1840
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• 2013

Metastasis is one of the hallmarks of malignant neoplasms and is the leading cause of death in many cancer patients. A major challenge in cancer treatment is to find better ways to specifically target tumor metastasis. In this study, the anti-metastatic potential of the methanolic extract of Rhizophora apiculata (R.apiculata) was evaluated using the B16F-10 melanoma induced lung metastasis model in C57BL/6 mice. Metastasis was induced in C57BL/6 mice by injecting highly metastatic B16F-10 melanoma cells through the lateral tail vein. Simultaneous treatment with R.apiculata extract (10 mg/kg b.wt (intraperitoneal) significantly (p<0.01) inhibited pulmonary tumor nodule formation (41.1 %) and also increased the life span (survival rate) 107.3 % of metastatic tumor bearing animals. The administration of R.apiculata extract significantly (p<0.01) reduced biochemical parameters such as lung collagen hydroxyproline, hexosamine, uronic acid content, serum nitric oxide (NO), ${\gamma}$-glutamyl transpeptidase (GGT) and sialic acid levels when compared to metastasis controls. These results correlated with lung histopathology analysis of R.apiculata extract treated mice showing reduction in lung metastasis and tumor masses. Taken together, our findings support that R.apiculata extract could be used as a potential anti-metastasis agent against lung cancer.